Tuesday, May 3, 2016

Medicaid and Churches

He’s five years old. He has Hypoplastic Left Heart Syndrome with Plastic Bronchitis. He was born with this condition and has endured many surgeries and hospitalizations.


There is no cure.

Plastic bronchitis is a condition in which bronchial casts, with rubber like consistency develop and cause airway obstruction. These casts build up and eventually break off and they are hard so he has to cough them out. Coughing these casts out is very difficult for him and is strenuous on his heart. Many medicines were tried but none helped, except one. It is an inhaler that he uses every four hours and reduces the build up of the casts.

The medication costs $24,000 a month.

He’s a vet. He’s in his 50’s. He’s soft spoken, doesn’t like to smile because he’s missing some teeth. He is a proud man. He has been living on the streets for almost a year. He finally agreed to meet with someone at the Denver House to discuss housing. He has nightmares. He served in the military, but he has never said when or for how long. He has medals but he won’t talk about the war. He’s alone. He refuses to make friends because he doesn’t want another one to die. He won’t go to the VA because, “There are many guys out there needing help more than me, I’ll make it.” After a long time he agreed to apply for disability. He disappears in thought often. When he “comes back” he is sad and full of guilt.

He struggles to make it through another day, but it is so tough because he can’t stop remembering.

He worked his whole life. He was a paint and body man. He paid his bills and when his mother-in-law gave him some land, they built a house. The kids remember vacations to California, camping trips to Keystone lake, TU football games, birthday parties and gifts beneath the Christmas tree every year.  When he could have retired, he continued to work as an estimator traveling all over Oklahoma. His dementia continued to get worse. He loved piddling in his yard, planting tomatoes and mowing the grass, burning trash. Then one day he fell and dislocated his shoulder. After ER visits and doctor visits he continued to decompensate. The family worked quickly to find a nursing home.

His life was forever changed.

On Medicaid the five year old received his medication each month. On Medicaid the Veteran received mental health services and medication. On Medicaid this hard working man moved into a nursing home.

I find it ironic that those who are vehemently against programs that help the poor and call those on Medicaid “lazy” are the same people who are too lazy to seek the truth.  It’s called generational prejudice, accepting what someone says as fact when instead it is a lie, and it is crushing the people of our state who are suffering. Maybe even someone you know.

Medicaid, Sooner Care in Oklahoma, covers low-income Oklahomans who otherwise go uninsured. “The majority of people covered by Medicaid are predominately children; the elderly and persons with disabilities. To qualify for Medicaid the individual must be both low-income and eligible to qualify by fitting into one of these categories: children, seniors and disabled adults, pregnant women and very low-income parents with dependent children.  Most healthy working-age adults in Oklahoma do not qualify for Medicaid. Oklahoma has the 45th lowest median income in the country for families with children and a quarter of the state’s children live in poverty.” *

We closed facilities that cared for adults with special needs that were too severe for their families to manage. We closed most of the psychiatric hospitals without putting services in place to care for those who had no family to take them in. The “institutions” were shut down before the community based services were established and funded. As time goes on these programs have never been fully funded and our neighbors, friends and family are falling through the cracks.

There are folks I see who are too mentally ill to recognize they need to stay on their medication. I see folks who have uncontrolled diabetes and cognitive deficits and no support system; they cannot manage the responsibility of taking care of their health much less managing a household even if they were placed in housing. The support services they need are being cut and there weren’t enough services to begin with.

There are individuals who are ready to go in for rehab for substance and alcohol abuse and can’t get in due to waiting lists that are weeks or months long. I see a couple of people who go to the Tulsa Center for Behavioral Health or the Crisis Center over and over again. Sometimes they are stabilized temporarily and discharged only to go back to the streets and the same environment that set them into crisis to begin with.

There are so many gaps in the system and with continued funding cuts, the gaps will get wider and every one of us will be touched personally by someone struggling with substance abuse, mental illness, someone who is suicidal, child abuse, elder abuse, homelessness, Alzheimer’s disease or a need for a nursing home. If you think I’m wrong, I can tell you that when you or your family member are blindsided by crisis, there won’t be services for you or your loved one. We cannot continue to live in denial and think if we ignore it, all of “that” will go away.

“That” is growing and getting worse and the needs are deep and complicated. Churches that pay someone’s electric bill or giving a bag of groceries isn’t even close to meeting the needs of our generational poor, our working poor and our middle class. The Iron Gate is the only agency that provides a hot meal every day of the year; they need the opportunity to expand.  The needs are growing not lessening, especially during the summer when kids are out of school.

Schools. We will not grow our economy with new business once potential businesses see how our state disregards our teachers and our students. It is truly shameful. How disheartening it is to see Tulsa’s philanthropists and foundations spending millions upon millions for a park when our working population, social services agencies and poor people are starving from neglect.

If the funding cuts that are looming over the Medicaid program go into effect, hospitals, nursing homes, mental health clinics will shut down. Which means all of those folks will go somewhere to look for help…and they’ll come to Tulsa, Oklahoma City, Bartlesville, etc. We can’t meet the needs we have now in Tulsa, much less when the refugees in rural areas begin arriving here seeking services.

I am so mortified by the hatred and blatant disrespect I see between political parties. I’m going to say it. In Oklahoma, we haven’t expanded Medicaid or even attempted to make the Affordable Care Act work because both programs came from a black President who is also a Democrat.

Really? We are so filled with stubborn pride and hatred that being against something irrationally is more important than the lives of our friends, family and neighbors. I am so heartbroken that no one has said, “I’m sorry. I was wrong. I will listen. I will compromise. I care.” Discourse is not possible because of an “us” against “them” attitude.  Leaders your stonewalling is creating a humanitarian crisis.

Why do we have to wait for tragedy to strike before we take action? Why can’t we be proactive to ensure that we have the services available and put prevention services in place? Why can’t people in power work together for the people of this state? Where is your sense of urgency? Where is your compassion? Where is your Christianity?

Please don’t remain in ignorant silence because the social issues are just too hard to face. Please take the time to write your Congressman, Senator, the Governor and ask them to support the Medicaid Rebalancing Act of 2020 and to support the Tobacco Tax. Take the time to learn more about these social issues before a crisis hits your family.

What more can be done?

We need step down services for the chronically mentally ill after they are discharged from a psychiatric facility. We need more sober living homes for those who make it through rehab and need a safe place to get their bearings back without going back to the same environment that set them into crisis to begin with.

There are seniors living alone all over our city. They are going without enough food, medication and socialization because they are not reaching out for help, either because they don’t know who to contact or they aren’t completely aware of how dire their situation is.

Child abuse is escalating in Oklahoma. If our children lose their Sooner Care, they won’t see a doctor for Well Child Checks, they won’t go in for immunizations and without the safety net of seeing a provider then we’re going to lose more children because no one will know they’re being abused. Special needs kids and disabled adults who require 24/7 caregiving by family and agencies, will suffer because those support systems will be cut and there will be no respite for the caregivers.

The Day Center is the only infirmary where homeless folks can go to recover after being hospitalized. Folks without insurance who need physical or occupational therapy or assistive devices or oxygen can’t get the help they need so they can’t heal properly. Many of these folks were working, contributing members of society until they were injured but without services they won’t be able to go back to work.

We need housing for folks who don’t qualify for other housing programs. We need day care that’s affordable for working moms and dads who don’t qualify for a DHS day care voucher. We need transportation for seniors to get to doctors’ appointments and for people who are working the night shift and don’t have a car. The city buses don’t run all night or on Sundays. We need to provide meals at times when there are no meals being served. We need to work with management of subsidized housing complexes to provide activities, classes and benevolence by caring enough to go into the complexes and getting to know the residents.

How can we afford to put all of these services in place?

Churches.

Churches will have multi-million dollar capital campaigns for more buildings to ensure the saved have a comfortable place to go to church with their kids. But where are the capital campaigns for people? To fill service gaps. To aid local non-profits who have to cut programs due to lack of funding.

“Did you know that Christians, in the name of Christ, have founded the majority of hospitals in the world? And that the church is still the largest single provider of health care in most of the world’s poorest places? And that the church leads the world in offering free health care to the terminally ill?...Churches founded 128 of the first 138 universities in America…programs for the poor and marginalized, such as free schooling for poor children, the world’s largest orphanage systems, and debt relief for the poor.” ** We need churches to get out of their pews and into the neighborhoods that surround them. We need churches to once again step forward and make a significant impact right here in our state.

What if a church did a capital campaign for buses? Buses that can take a senior to the grocery store or take a working mom to work or a student to school. Buses that pick up working folks from the night shift.

What if a church did a capital campaign for local sober living ministries so they can expand and care for more people? What if churches opened their kitchens and served a meal a week that was open to everyone, no charge. If you want to know the needs of the people in and around your church…just share a meal with them.

What if churches established medical benevolence ministries? Paying for Physical Therapy and Occupational Therapy for folks without insurance. Paying for medicine. Paying for doctor’s appointments, paying for oxygen, providing bedside commodes and hospital beds. Isaiah 58, In His service is doing what we can to be a ministry “gap filler” by helping with some of these needs.

What if churches partnered with Aim High Academy, Crisis Pregnancy Outreach, The Day Center, Indian Health Care Resource Center, Iron Gate, Life Senior Services, The Little Light House, Manna House, Mental Health Association, TARC and even DHS and had capital campaigns that helped sustain these agencies and helped them grow to help the enormous numbers of people in need and walked with them for the long term, to ensure financial stability? I named just a few there are so many amazing agencies in our community that are ready and waiting to partner with a church for the long haul.

What if churches hired a licensed and degreed Social Worker? A Social Worker can triage the folks in need who show up at our churches. With a network in place and capital campaigns providing services that fill the gaps, think of how many folks we could love on? Social Workers would meet with Social Workers at other churches and non-profits so all of the services available would be known by all. That way we would have less duplication of services and when we recognize another gap, then we get another church involved.

Wouldn’t it be great if we worked together for the better of our community? We remember what compassion is and empathy and we listen and respond with a heart’s desire to meet needs and improve lives. By doing so, we can learn to work together again, and recognize we are more alike than we are different and we will regain our humanity of doing unto others as we would want others to do unto us.

Oh, the man I mentioned earlier? The one who had to be put into a nursing home?

That was my Dad.

He worked his whole life to provide for his family. He and my Mom would go without so we kids could get stuff we really didn’t need. I remember really wanting a mini-bike because my friend across the street had one. They made sure I got one. For many years, on July 4th we would celebrate in our back yard. Relatives and friends would come over for ribs or steak or chicken that my Dad would grill; fresh corn on the cob, watermelon, homemade ice cream and of course a big fireworks show at the end of the night.

My Mom and Dad didn’t save a whole lot because they never made a whole lot. But, they voted and paid their taxes and my Dad was an incredibly generous man. He gave to many non-profits that we never knew about until he could no longer open and read his mail. My Dad lazy? Absolutely not.

When we had to put Dad into a memory care nursing home, my Mom paid out of pocket until he qualified for Medicaid. It was such a difficult time for my family.

What happened to my Dad could happen to your Mom or your Dad too.

If there was no Medicaid available we would have spent all of my parent’s savings in less than a year. My sisters and I could not afford $4,500 month to keep him in there. We needed hope.

That hope was Medicaid.

In His service,

deni A. fholer, LMSW, CCFP
executive director/president
Isaiah 58, In His service, Inc.
PO Box 521063
Tulsa OK 74152
918-260-1933
I58ihs@gmail.com
www.i58ihs.blogspot.com
501©3 nonprofit ministry
                              We can do more. We can do better.
*Medicaid 101: The Sooner Care safety Net, OK Policy.org, Oklahoma Policy Institute
**God for the Rest of Us by Vince Antonucci
To learn more go to: http://okpolicy.org/files/Medicaid%20101%20SoonerCare%20Safety%20Net.pdf?b0f37e
To guide you in encouraging your church to start a capital campaign read:
Barefoot Church by Brandon Hatmaker
May 03, 2016


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